2090 Carnelian Lanes-3 ----.s ---? __.
INSPECTIUN RECORD
/CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55122-1897 Date Issued:
(612) 681-4675 .
'+ I y? I J ' s• .y +' 4.?
' i t f I ; "i !; ? ?1,! !., ;, c.
? SITE ADDRESS: APPLICANT:
l c lll?i 1AN[
? i t l i i G' i 1 1 { •. !. ? ? ? S . )? . ? ? F• .1. : ? ? r . ! ?? ? .? G'? ? R Yg
PERMIT, SUBTYPE: TYPE OF WORK: r, f ,.A if?
' i;. 1. i i ? i 1; i,i k; F E•> #. A R,: 1' S fV {I
RAM7l+i1,
1 PJ111
?
?
Permit Holder Date Telephone #
PLUMBING
H VAC
inspection Date Insp. Comments
FOOTINGS
FOUND
FRAMING
ROOFING
ROUGH
PLUMBING
PLBG
AI R TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL
GYPBOARD
FIREPLACE
FIREPLACE
AIR TEST !
FINAL PLBG
FINAL HTG
ORSAT
TEST
BLDG FINAL
DOMESTIC
METER
IRRIGATION
METER
FLUSH
MAINS
CONDUCTIVITY
TEST
HYDROSTATIC
TEST
BSMT R.I.
BSMT FINAL
DECK FTG
DECK FINAL
2005 RESIDENTIAL BUILDING PERMIT APPLICATION
City Of Eagan
C1?5 '1 y-' 3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
ca, `7 0 c) c)
New Construclion Reauiremenls RamodeUReoair Reauiremenls Office Use Onlv
3 regislered sile surveys showing sq. ft of l04 sq. ft. of house; and all roofed areas 2 copies of plan Cert of Survey Recd _ Y_ N
(20% maximum lot coverage allowed) 1 set of Energy Calculalions for heated addilbns Tree Pres PWn Recd Y N
2 copies af plan showing beam 8windowsizes; poured found design, etc. 1 site survey faradditions & decks Tree Pres Required Y _N
lsetofEnergyCalculatlons Add'rtian-Indkafedon-sitesepficsystem On-sIteSeptlcSystem _Y _N
3 copies of Tree Preservatbn Plan A lat platted aher 711193
Rim Joist Dehail Options selecl'an sheet (buildings with 3 orless unAs)
r
Date ko / ?C>7>
Construction Cost
SiteAddress 2 U`_7(7 r& L,????'-J L? Unit/Ste#
Description ot Work / N 57111L 64> 52?Lr
Multi-Family Bldg _ Y_ N Fireplace(s) _ 0 -k1 _ 2
Praperty Owner Telephone # ( )
? l
P
f ? L 0
l CL
Contractor
,
L. `
Address 13 City
State lilAJ Zip 7? 3? 7 Telephone #(`j?
COMPLETE THIS AREA ONLY IF
Energy Code Category - Minnesota Rules 7670 Cateeorv 1 _
(J submission type) • Residential Ventilalion Category 1 Worksheet
Submitted
• Energy Envelope Calculations Submitted
A NEW BUILDING
Minnesota Rules 7672
. New Energy Code Worksheet
Submitted
Have you previously consiructed a building in Eagan with a similar plan2 _ Y _
fee applies.
Licensed Plumber Telephone #(
Mechanical Contractor
Sewer/Water Contractor
Telephone #(
Telephone #(
N If so, 25% plan review
I hereby apply for a Residential Building Permit and acknowledge that the information is complete and accurate;
that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN
Statutes; I understand this is not a permit, but only an application for a permit, and work is not to start without a
permit; that the work will be in accordance with the approved pl in the case of wor hich requires a review and
approval of pl s.
?Ni`.' d"!`L-//?) NI ?
Applicant's Printed Name
Signature
4 2005
? - _--
FERMIT
QITY-OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
SITE ADDRESS:
P.I.N.: 10-16702-050-05
PERMIT TYPE:
Permit Number:
Date Issued:
2090 CARNELTAN LANE
LOT: 5 BLOCK: 5
CEOAR GROVE #3
BUILDING
093475
09/25/98
DESCRIPTION: Re P Lp c E
B u,i„i n:g,., P e r m i t T y p e
B,t;ild?ng"Wl?a,rk Type
C.ensus Ca, de
f,
?.
Y.
Y,. _. .
l.i?y.x32fl.A bd ' ?? YJ "A
,s,= - .?
r., .r
af.r`
?'.
't
?w
SSDING
5F (MISC.)
REPAIR
434 ALT. RESIDENTIAI
?s
? p
??[i1
?? "r
.., ._ ??il'`.
. ".r
REMARKS:
FEESUMMARY: vflLuATxoN $5,e0e
Base Fee $99,75
Surcharge _ $ 2.?p
Total Fee $102.25
SFFFREY'?TA'fiE5 CONSTRUCTION116742008 2631LIC $C?HAJF?ER ,70HN
I N.O. BOX 576 2090 CARNELIAN LANE
NdRTH BRANCH MN 55056 EAGAN MN 55122
.(612) 574-2009 (651)454-8482
?
I hereby acknowledge that T have read th3s app5ication and 3tate tihat''the
, ?n1`arma,tiqn iis qo.rrect ond ag r,,ee, to cdmpli?hr al.l, apF,L?;cable StatB af htn.
Statutes and tity of Eagan,Ord3nances. '
APPLIGANT/PERMITEE SIGNATURE QSSUED BY: SIGNATU RE
, . 1998 BUILDING
New Construction Requirements
PERMIT APPLICATION
CITY OF EAC,"pN
3830 PII.OT KNOB RD - 55122
661-4675
? 3 registered site surveys
? 2 copies of plans (inGude beam 8 window s¢es: poured fid. design; etc.)
? 1 energy calcuiations
• 3 wpies of Vee preservation plan rf lot platted aRer 7/1/99
required: _ Yes _ No
DATE: (q
DESCRIPTION OF WORK: , * , r?I l Jlt?..s:r?.lw o'?
STREET ADDRESS: ? 0,10 ? e(' ri c? l?4 ` L ? h
(RESIDENTIAL)
I I aa.a5
Re?, modeUReoair Reauirements
u
• 2 capies of plan
? 2 sita surveys (e#erior additions 8 decks)
• 1 energy calculations for heated addRions
O?
CONSTRUCTION COST; ?d ? f
LOT: BLOCK: SUBD./P.I.D. #: ?P?ti G Y O V`e ?-3
Name:? -?o ?? P6one #:
PROPERTY Laet First
OWNER i
Street Address: ?ci r ne?' w<--
City ? °Ry Stare: Zip:
Company:_,,?1"?e4 Phone#: b?4 ;?D?O
CONTRACTOR (? p ' 3 f"'? ? ) l el G Qj
Street Address: ro pa'S)? License #
Ciry J" oS`t?j c,vy-" State: V'-? Zip: 6-'r,-DS b
ARCHITECT/
ENGINEER Company: Phone #:
Nazne: Registration #:
Street Address:
City State: Zip:
Sewer 8 water licensed piumber (new consdvction onty):
and lot change is requested once permit is issued.
Penalty applies when address chan!
I hereby acknowledge that I have read this applica6on and state that th4 information is correct and agree to comply with all applicat
State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Applicant:
?
OFFICE USE ONLY
Certificates of Survey Received _ Yes _ No
Tree Preservation Plan Received - Yes - No - Not Required
-- % , -l
BUILDING PERMIT TYPE
? 01 Foundation ? 06 Duplex
? 02 SF Dwelling ? 07 4-plex
? 03 SF Addition ? 08 8-plex
? 04 SF Porch 0 09 12-plex
? 05 SF Misc. ? 10 _-plex
WORK TYPE
? 31 New O 33 Alterations
? 32 Addition ? 34 Repair
GENERAL INFORMATION
Const. (Actual)
(Allowable)
UBC Occupancy
Zoning
# of 5fories
Length
Depth
APPROVALS
Planning
OFFICE USE ONLY
? 11 Apt./Lodging ? 16 Bpsement Finish
? 12 Multi RepaidRem. O 17 Swim Pool
? 13 Garage/Accessory ? 20 Public Facility
? 14 Fireplace ? 21 Miscellaneous
? 15 Deck °
0 36 Move I
? 37 Demolition
I
Basement sq. ft.
Main level sq. ft.
sq.ft.
sq. ft.
sq. ft.
sq.ft.
Footprint sq. ft.
Building Engineering
MCNVS System i
City Water
Fire Sprinklered
PRV
Booster Pump ?
Census Code.
SAC Code
Census Bldg I
Census Unit
Variance I
Permit Fee q - -75?
Surcharge
Plan Review
license MC/WS SAC
City SAC
Water Conn.
Water Meter
Acct. Depasit
S/W Permit
S/W Surcharge
Treatment PI.
Park Ded.
Trails Ded.
Other
Copies
TotaL• l 0 "d - a IS-
Valuation: $
% SAC
SAC Units
CITY OF EAGAN
Addition Cedar Grove #3
Cedar Grove
_Lat J Qlk
2090 Carnelian Lane
10 1
smte Eagan?MNII 55122
1n.dt-w ?'.u.onlim.ti ?e- 45 9 - 1424
Improvement Date Amount Annual Vears Payment Receipt Date
STREET SURF.
STREET RESTOR.
GRADING
SAN SEW TRUNK
,ESEWERLATERAL n 1972 130 .00 2,1 2
WATERMAIN
# WATER LATERAL 1972
WATER AREA '
STORM SEW TRK
STORM SEW LAT
CURB & GUTTER
SIDEWALK
STREET LIGHT
WATER CONN.
6UILDING PER.
SAC
PARK
EAGAlV TOWNSHIP
BUILDING PERMIT
Ownex ....... ?.
1'ruc? -°--^..c-'----_....-----------_....._..
Addresa (Presenl) -...._?.`..:-?:_`..------------..
Builder ------?r.!_ ?1:r.??...s.A1................... °................. .-------- --
Address
..............
DESCRIPTION
N° 1397
Eagan Townsbip
Town Hall
Dafe ._......'r:??G4.......................
Siories To Be Used Fos Fronf Depih Heighi Esi. CosS Permi! Fee Romarks
v v LOCATION
or
15 1 5 I r.(,. _i?,
This permif does aot auYhorize the use of sireels, roads, aileys or sidewalks nor does it give the omner or his agenf
the right to czeate aap siiuafion which is a nuisance or which presenSS a haaard lo the hea]!h, safeiy, eonvenienee and
general welfare !o anpone in the commuaity.
THIS PERMIT MUST BE PT ON THE PA£MISE WHILE THE WOAK IS IN PRO_G?RE*S.,
This is !o ceriifp, -----_----------_-.... haspezmissioa !o erect a__'..?p?..4-..?_uPOn
!he above dascribed premise subjec! !o the provisions of the Building Ordiaaace foe ??aqan Township adopled April 11,
1955. //
?
............................... .................... Per ............ l6c:e?t"'--...... 6.'r---.. ??E? .................
Chairman of Tnwn SoaRl B Buildin Insp eelor
EAGAN `COVO/N S H 1 P
BUILDINC PERMIT
Ownex
....._.' . ........ . .. ... . .
Address (preseni)..
..
Builder ............................................... _ ... ... ---...
Address .... ........... _..----'-------
....--"------------ .._..---_.----- ._.....----'
? DESCRIPTION
M 1060
Eagan Township
Town Hall
Dale '__.._....."......_..................... ..
Sfories
-- To Be Used For
- Fron1 Dep1h
-?--I---- Heighi? Esi. Cosi
' P
rmif Fee
Remarks
/?
}u''„'4. C?,?.?y•
?' ?
---
-
-------
or
LOCATION
or lraci
` -- q _ ro _ ,C3.E s
, 3 - y i
This permil 8oes o-It aufho?r'ue ?he use ot slreeis, roads, alleys or sidewalks nor does it give the owner or his agent
the :ighf !o create any siluaiion which is a nuisence or which presenls a hazard !o the healih, safety, convenience and
general weSfare fo anpone in the eommunify. THIS PEAMIT MIIST BE KEPT ON THE PAEMISE WFiILE THE WORK IS IN PROGRE55. ,
This is !o eerlifY, ---- _._.......... has permission io ereet a...,'/q.... '? -''k•?j'. ._..........upon
the above described premise subjeef to the provisions of the Buiidinq Ordinance for Eagan Td4,nship ad'6ptr.d April 11,
1955.
.-?y} /?/? .? ?aC. ,,y ??' p /
.......... ..... _.......'?.G4.Gt?L[--'??-.'-.?,?.:r.?.'..._._...._._. Pex _....---..__4'?-?E^ ,/'?^'??1?? f?l, ... ....... .......
. ? .... .. ........2 :
Chaiiman of Tnwn Boerd ? Building Inspecior
Q?.fi•
This reqaest void f Lj r 7)
?Bmol ?rr54?" . -,
Ls, gs? cT-- ck o.c- &
CV,o? ? ?(f'-
33(15C„
Coc ao
Req ue t D ?ry?
1?-?-CS`L Fre No. Fouph-?ilnsUecUOn
Re4???red>
[''?ReaAY Nuw Q Will Nu1dy Insoec-
Gy?,G ror When fleady
? Liy(e?sed Electncal Conlractor I hereby requnst inspecM1On of ebova
? Owner electncal work installed ar
Stree[ Adtlress, eox or Route No. Citv
2020 Carnelian Ln. Eagan
ecLOn o. Townshi0 Npme or Na. Ran9e No. Coumy
Dakota
Occupani (PRINT) Pho?e o.
?
David Aloane -3993
?5
Power SuoVlier Adtlress
Elacvical Cnmractor ICOmpany Name) Co
r?!rnnt2rs l6cense Nn. .
Rossow, Inc, µVo
MaJing Address (CoMrnctor or Owner Making Instailauon)
P.O, Box 254 Lake Elmo, Mn. 55042
Auth e ipnawre (ConVactor/Owner Making InstallatLun) Phone Number
770-so46
MIryIIESOTp STATE BOAHD OF ELECTflIC1TY - ' THIS INSPECTION NEpUEST WILL NOT
GriB9s-Midwey Blde. - Aoom N-191 BE ACCEPTED 8V TFIE STATE BOARO
1827 UnoversitV Ave., St. Paul. MN 55104 , UNLESS PNOPER INSPECTION FEE IS
o1.....e 19171 147_111, ENCLOSED.
REQ.?EST FOR ELECTRICAL INSPECTION w-, EB-OO007-Oi
Sae i?tructfons for camplflUng this form on back ot yellow cupy.
T 7654? "
X" Below Wqrk Covered by Thrs Requesl ' ?j 3 4 S(o
Ne% Add Rep. Type ot Bmldinp AOPlfancas Wiretl Equipmant Wired
}C Home Range Temporary Service
Duplex Water Heater Liyhtin Fixtures
Apt. Bwidin,y Dryer Electric Heatin
Commercial Bldy. Fumace Silo Unloader
Industrial Bldg. Air CondiLOner Bidk Milk Tank
F2rm Other pev v Othr.r ISUentyl
thnr SGCwfy Othcr Othpr
Compute lnspecbon fee Below
p Fee ServiceEnhenceSiEe a Fee feeders/Subfexders N Fee Cvcuits
0 to 100 Am ps 0 to 30 Am s 0 to 30 Am s
1 at to 200 qmps 31 to 100 qmps 31 to 100 Am s
Ahove 200 qmps Above 100_Am s Above 100_Am s
Transtormers Remote Control Circ. Partial%Other Fee
Signs Special InspecLOn 5 T
Ren i?ks O FE
?
w -
Rough-in Dat r. ,, tha cel
? ? NA Inspectoq hereby
Final ????P inspection,has been I
X_
made.
This re4uest void
1R --m? 1...e,
Th;s d4.as w d 1 I 1 a o? ^ O 6
? 5 -
C5h4929 C, 5 , 8 - cz-& -X!
AequeSt Date
1j fire No. Rough-in Insnec?.on
HeQwred>
OHeady Wow II Novfy InsPec-
/
// ?Ves ?NO ?or When qeady
WILicensed Electrical Convxctor I hereby repuast inspaction o1 ebove
Owner eloetr{cal work irmtal
Sireet Address, eoz o oute No. • Cit
p ?
e ion o. Towns ,p Name or No. ' Ranpe No. County
Otcupnnt (PBINT Phone No.
7?c7-
Power S
?
? Atldress
6f
3? ' ?
?
??
a, ? •
Q,
, ,
. .
- j? a?
Ele al Co ha tor ICO pan Namel
?A Contractor's License No.
Mailin0 Jress (Co ctor or Owner Making Instailatio 1
?
,
Autnor ze SiBnatur Contra or Owne king InsWllation) Ph e Number
MINNESOTA STATE BOARO OF ELECTPICITY TMIS INSPECTION NEQUEST WILL NOT
ONqps-Mitlwey Bldq. - Room N•181 BE ACCEPTED BY THE STATE 60ARD
1827 Univereitv pvs..81. Paul. MN 65104 UNLESS PROPER INSPECTION FEE IS
phnna1pl?l ta2 Man ENCLOSEO.
REQUEST FUR ELECTRICAL INSPECTION ee-ooooi-oe
0 bea inatructions lor complatin0 thia form on beck of vellow eopy.
C.ri d qp4A3Gk-?K'selow Work Covered by This Request
ol Bu,IEinq
Ik
M Fee Service EntrenCe Sixe d ' Fea Feadars/Subteetlars N Fea Circuits
? 0 to200qm 5 0 to30Am s 0 tn30Am s
A6ove 200 qm ? 37 to 100 qmps 31 to 100 An?m
Swimmin Pool , Above 100_Am s Above 100_P.m s
Transformers rn ation Booms Pertia6'Other F e
l iS- V V / V S`l ?/
I 13 2 9 6 ' je-- g s= 3 ?-z
ReQUest Date
4- Fve o Roughtin Inspeclion
Requaretll
Ves o
ea0y Now p Will Notity Inspector
When Featly'+
I hcensed contractor p owner hereby request inspection of above electrical work at.
JoD Atlaress street Box or Roule No ?
9n CO-rY1e?i? L1'1• Qry
?a a-n
Seclmn No TownsM1ip Name or No Range No Co I
10.?
p,clPRIn 5 Phane No
Power Sup0lier AtlOress
EI Incal Comracto? ICOmp Name)
Q? c- Gonlractor's License N.
CF?o il9a
Mahng qtltlress iCOnvacioi or Owner Making Instel tion)
P?oo a.e fkt? S
1gnaWre
vaclonOwner Mabng Installauon) ?
!
0 -3SSS"
116
MINNESOTA STAT BO ND ECTRICITY TNIS INSPECTION REpIJEST WILI NOT
Grigga-Mitlway BI Room 3 BE AGCEPTED 6Y THE STATE BOARO
1821 University Ave. St Paul. MN SStpG UNLESS PqOPER INSPECTION FEE IS
Phane (811) 642-0800 ENCLOSED
? REQUEST FOR ELECTRICAL INSPECTION ;°.yn??=`w ? ee-oooo,-oe
,. , op See insimctions lor compleling Ihis form on back of yellow copy SP 37
? 'X" 8elow Work Covered by This Request "???:•??° A(-3,Z ^ 75
ew Add Rep. TypeofBwldmg AppliancesWired EquipmemWued
Home Range Temporary Serwce
Duplex Water Heater Eleciric Heating
Apt. Building Dryer O[her (Specify)
Comm.llntlustnal Furnace
Farm Air Conditioner
Other ?specdyl Con[aotor§ RemarNS ?
Compute lnspechon Fee Below:
p Olher Fee # ServiceEniranceSrze Fee # Qrcuits/Feeders Fee
Swimming Pool 0[0 200 Amps 0 to 100 Amps
Transiormers Above 200 _ Amps A6ove 100 _ Amps
Signs inspecmrs use oniy TO7AL
Irrigation Booms
Special Inspection
? /? V?/
Alarm/Commumca0on THIS INSTALLATION MAY BE OR CONNECTED IF NOT
Other Fee COMPLETED WITHIN 18 MONTHS.
I, the Eledncal Inspecroc hereby RO°9n-?n oate
certify that the above inspection has
been made Dete
OFFICE IlSE ONLY
Tnis request voitl 18 montns Irom
S 3 ° +" RESIDENTIAL
BUILDING PERMIT APPLICATION
CITY OP EAGAN '
3830 PILOT KNOB RD, EACAN MN 55122
651-681-4675
New Construction Reauirements ' RemodaYReoair Reawrements
• ;:egisterea ide surveys showmg sq. ft of ;ot, sq k. of house, anE all raofed areas • 2 capies of plan
(20 a maximum lot coverage allowe0) I set of Energy Calculations for heate0 additions
• ?.:ocies of plan shownig beam 3 window s¢es, poured fountl 7esign, elc . 1 sile survey for extenor additions 8 decks
• t;zt ol Eneryy Calcuiations . indicate ?f hame ierveC by septic syslem for additwns
. 7 copies of i ree Preservation Plan if lot platted after 711193
• Rim Joist Detail Opnons selecdon sheet (hldgs with 3 or less umis)
DATE oGk VALUATION ?--
SITE ADDRESS
TYPE OF WORI
iULTI-FAMILYBLDG _Y _N
PIREPLACE(S) _ 0 _ 1 _ 2
APPUCANT?"t2?\Y?1? lCrf??nG
STREETADDRESS f?;ZOQ I1..3"]PSi CITYF??C\A _STATOI1v ZIP9?q'-n
TELEPHONE #k950A(Y.35-9707?CELL PHO IE # FAX #
V PROPERTY OWNER TELEPHONE #
,
----------------------------- ------------------------------------------------------ ------------
COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINVF:SOT.1 RCI.GS 7670 C.A'PF.GOItYpt I N[IVNG50'fA LtCL1•:5 7672
submission rype) • Residential VenWatlon Category 1 Worksheet Su6mitted • New Energy Code Worksheet Submitted
• Energy Envelope Calculations Submitted
Plumbing Contractor: ____
Plumbine sy's[cm includes:
Mechanicol Contractor:
Mcch:uuu.il scs[cm includrs:
Sewer/Water Contractor:
.air Condiuoniiilg '
I-[cat Rccoccn• Scstcm
Fee: $90.00
?In 112002
---•--------------------------------------------------------------•----=---•-'--------- --------
I hereby acknowledge that I have read this application, state that the information is corre t, and agree to comply
with all applicable State of Minnesota Statutes and City of Eagan na ' ?
Signature of Applicanf I
OFFICE USE ONLY
_ Water SoFtener
4Va[er Heater
No. of I3aths
Phone n
_ Latim' Sprinkler
No. of R.I. Baths
Certificates of Survey Received _ Tree Preservation Plan Recerved _ Not Reqwred _
Updated 4/02
PERMIT# ??99-3
SOOE iiESIDEPTIlkI. PLUM$IA6 PE
crrY oF EaeaLv
3830 Pnoz [uvos fu
Eksstv, auu ssiEs
651-661-4675
Please complete for: single family dwellings, Wwnhomes and condos whei
backflow preventer for irrigation system
SITE ADDRESS: OCl
OWNERNAME:: T?
INSTALLER NAME: i ? \ V
STREET ADDRESS: ?[ UCJ
CITY: LQ-6aV1UQ. , ( '
i
permits are required for
p RT ? p M??
FEB 0 7 ?np7 I ?I
iV ?50 L
#: - io a
(ARE)
-6 9
( EA CODE)
TE:' ZIP:
_ SEPTIC SYSTEM, new/refurbished (requires two sets of plans and MPC license) $ 100.00
includes $40.00 County fee I
Note: Additional consultant fees may apply
• MODIFICATION/ALTERATION TO EXISTING DWELLING UNIT, INCLUDING:
_ Adding fixtures to lower levels or room additions, excluding water so eners and water heaters. $ 50.00
_ A6andonment of septic system.
_ Water turnaround - ewsting dwelling unit (+ 5/8" meter if needed -$ 718) +
Other:
_ RPZ: new installation/repairlrebuild
_ lawn irrigation system ?
ReplacemenUadditional: _ water softener kater heater
, $ 15.00
l
State Surcharge l
I
$ .50
t
l $ ?
TO
a
I hereby acknowledge that I have read ihis epplication, slate thal the Informadon is covect, 8nd ag comply with all a
is the applipnPs responsfbllity lo notify the property owner thatthe Cityof Eagan assumei no Ifa , I for any damages
operational and malntenance activities to the tacilities consVUCted under tlhis permit widiir? Ciry ro lrjqht-of•way/,p
RECEIPT DATE:
: City of Eagan ordinances. It
by the City during ifs normal
1/02
� Use BLUE or BLACK Ink
r------------------�
I For Office Use �
� � Permit#:��� � � -I �
Clty of �a��� � . 5 0 �
Permit Fee: D.,
3830 Pilot Knob Road I I
Eagan MN 55122 � Date Received: t a����� I
Phone: (651)675-5675 � ,n� �
Fax: (651)675-5694 � Staff: ��`�� �
I ' I
2014 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: Unit#:
Name o} �����'l. [�.J�� Phone: �D�� ��q 2 ���D
e e
Address/City/Zip: ���'� C*��1J�C ��� �fJ�
Applicant is: Owner � Contractor
r
Description of work: ��'���. "� �(� C LP. ' Q �`�
Construction Cost: �'�i'��� Multi-Family Building:(Yes /No�)
Company: �a�i 5,.?l)� C�LcrSs ��Ju'?�'`.�^�� Contact:��� �j-�7� _C�C d�
,Qa.. ;�
Address: L�� ��a` �;. ,J� S'r � �� City: ��U°���
State: � l�" Zip: ���� Phone:�J5����NJ�--��( Email: ���_����f C
License#:�,L ����� 0 Lead Certificate#: r"�fi� l � ° � u � " J
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information}
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
_Yes _No If yes,date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer&Water Contractor: Phone:
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CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protection against underground utility damage. Call 48 hours
before you intend to dig to receive locates of underground utilities. www.qopherstateonecall.orq
I hereby acknowledge that this information is complete and accurate;that the work will be in confo nce with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is n to start without a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of pla .
Exterior work authorized by a building permit issued in accordance with the Minnesota S e Building�`Code must be completed within 180
days of permit issuance. ,,�-~`"
X_ �l�x .��s5� X
ApplicanYs Printed Name ' ant's Signature
Page 1 of 3
Use BLUE or BLACK Ink
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I For Office Use �
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• � Permit#: � ��O I
City of �a��� � �G- �
� Permit Fee: �
3830 Pilot Knob Road j �
Eagan MN 55122 � Date Received: I
Phone: (651) 675-5675 � i
� Staff:
Fax: (651) 675-5694 �_________________�
2015 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: ���� `'/5 Site Address: ��,� �/"��-�.- �
Tenant: Suite#:
�
� �.. � ; Name: Phone:
E��tS�
�t = Address/City/Zip:
�� _ Name: C..�I��'1 ��i ,�'/��I��l�z License#: �'/� 06 3771
�.�
,s /� /� /
° ; Address: �,�<f IYC����fJ9i�� t���i,o City; �.c G�J _
-. .:�
� :
� � � ¢ �� ��''�� ��l�.. Phone: �'J�t�3�-S ` y���
� State: Zip:
Contact: ��/� Email: ��.� /� ������ ��
-���� � �y ��� � New i�`Replacement _Repair _Rebuild _Modify Space Work in R.O.W.
����� � fi j� � — — —
g``��= c 4� Descri tion of work:
��_ ..�� _ �� . � p
� �
RESIDENTIAL
� ' �f ��
� '��� �;
�-� �� _- �Water Heater
- Water Softener
- Lawn Irrigation(_RPZ/_PVB)
�- � �Add Plumbing Fixtures�Main/�Lower Level)
,�i �,T� ����� t Septic System
� - � ��
� ;�"� �����r±�,,, Water Turnaround
� � : New
� � 3�b :
Abandonment
RESIDENTIAL FEES:
$60.00 Water Heater, Water Softener, or Water Heater and Softener(includes$5.00 State Surcharge)
$60.00 Lawn Irrigation(includes$5.00 minimum State Surcharge)
$60.00 Add Plumbing Fixtures, Septic Sxstem Abandonment,Water Turnaround'`(includes$5.00 State Surcharge)
"`Water Turnaround (add$200.00 if a 5/8"meter is required)
$115.00 Septic System New($10.00 per as built)(includes County fee and$5.00 State Surcharge)
TOTAL FEES $
CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protection against underground utility damage.
Call 48 hours before you intend to dig to receive locates of underground utilities. www.qopherstateonecall.orq
I hereby acknowledge that this information is complete and accurate;that the work will be in confoRnance ' the o inances and codes of the Gity of
Eagan; that I understand this is not a permit, but only an application for a permi,and is not to art without permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and appr al of plans.
X �(�t l�r �i�r� �lr �(� X
Applicant' Printe am Applica ' i nature
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Use BLUE or BLACK Ink
For Office Use/ �CC_:::::'
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ty ��� � //a
3830 Pilot Knob Road
Eagan MN 55122 Date Received:
Phone:(651)675-5675
buildinginspectionsacityofeagan.com Staff:
2017 RESIDENTIAL BUILDING PERMIT APPLICATION
Q1
Date: f U/ 1 1 Site Address: 2-15 q 0 Ca'-v' 1 t0‘...A, Unit#:
Name: 3 M-'('1 Icer tt Phone: b LI l 2 - ' s!
Resident/
Owner Address/City/Zip: 2,0610 Cot. Mt( i c.n la Ast Fn a,ir- 1 h
Applicant is: Owner X Contractor
Q.c� i ec C. - L s id.a 1,4 K6 t4- i1rr
Type of Work
Description of work: C v . `�
Construction Cost: 17 6 0 c) Multi-Family Building:(Yes /No)1 )
Company: N 6- C0v"trGt.CON h e_ Contact: I CIM Aka. { ' l
Contractor Address:,�teo "I AVC N Sit t O City: A-.N()KA
r�� `1b32Cf6i13 ii
State: Mi w •Zip: 5C;303 Phone: mail: `1 �i/lc(C61n* t0 IC.r✓
eses License#:j to b I 1�/) I Lead Certificate#: F 5 9 t1' -` 1
If the project is exempt from lead certification, please explain why:
COMPLETE THIS AREA ONLY IF CONSTRUCTING ANEW BUILDING
In the last 12 months,has the City of Eagan issued a permit for a similar plan based on a master plan?
Yes No If yes,date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer&Water Contractor: Phone:
Fire Suppression Contractor: Phone:
NOTE Plans and supporting documents that you submit are considered to be public information. Portions of the
information may be classified as non-public if you provide specific reasons that would permit the City to conclude that they
are trade secrets.
You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on
the City's website at www.cityofeaoan.com/subscribe.
Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180
days of permit issuance.
CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protection against underground utility damage. Call 48 hours before
you intend to dig to receive locates of underground utilities. www.gopherstateonecall.orq
I hereby acknowledge that this information is complete and accurate;that the work will be i. .•nformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, an. ork i not to start without a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and app rival of pl.ns.
x J \ Ma(SCA
Applicant's Printed me Ap 'cant's Signature
Page 1 of 3